The primary aim is to test differences in the effectiveness of three tratments for dyspnea: Education about dyspnea; nurse-coached exposure to dyspnea with education; and a model of pulmonary rehabilitation with high-intensity exercise and education. All subjects will receive a home exercise prescription. Ninety dyspnea-limited COPD patients will be assigned randomly to one of three treatment groups for one year. The GCRC wil be involved in measurement of demographic data, and outcomes, e.g., 6 minute walk distance and dyspnea with activities.